Active NPI
Raman L. Mitra, M.D.
- Clinical Cardiac Electrophysiology Physician
- South Bend, IN
National Provider Identifier
1528062221
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Cardiac Electrophysiology Physician
- License
- 01045628A
- Practice address
- 610 N Michigan St
Suite 400
South Bend, IN 46601-1077 - Phone
- (574) 647-8120
- Fax
- (574) 647-8111
- NPI assigned
- Jun 9, 2005
- Last updated
- Jul 26, 2012
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Cardiac Electrophysiology Physician | 207RC0001X | 01045628A | IN | Primary |
Addresses
Primary practice location
610 N Michigan St
Suite 400
South Bend, IN 46601-1077
Mailing address
610 N Michigan St
Suite 400
South Bend, IN 46601-1077
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200102610 | Medicaid | IN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Cardiac Electrophysiology
- Education
- Perelman School of Med at the University of Pennsylvania, 1985
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
300 Community Dr
Manhasset, NY 11030-3816
Phone (516) 562-3058
Hospital & facility affiliations
- North Shore University Hospital
- Long Island Jewish Medical Center
- Northwell Hospital Glen Cove
- St John's Episcopal Hospital at South Shore
Merit-based Incentive Payment System (MIPS)
- Final score
- 93.07 of 100
- Quality
- 79.77
- Promoting interoperability
- 88.77
- Improvement activities
- 40
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Pacemaker insertion or repair | 49 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 01045628A | IN | MD | Clinical Cardiac Electrophysiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| North Shore-Lij Medical PC | Current | Accepting new patients | |
| North Shore - Lij Medical PC | Current | Accepting new patients | |
| Midwest Medical Group, LLC | Past | Accepting new patients | |
| North Shore University Hospital | Past | Accepting new patients |
Locations
10201 66th Rd
Forest Hills, NY 11375
Phone (718) 830-4091
300 Community Dr
Manhasset, NY 11030
972 Brush Hollow Rd
Westbury, NY 11590
Networks
- Healthfirst Medicare Network H5989
- Healthfirst Medicare Network H1722
- Healthfirst Medicare Network H9678
- Healthfirst Medicare Network H3359
Interoperability endpoints
- ramanmitra@nslijmedgr.allscriptsdirect.net
Organizations & group practices 4
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba NHPP Cardiology at Great Neck
- Urology Physician
- Great Neck, NY
- NPI 1053688572
-
dba NSLIJ Medical In Queens
- Internal Medicine Physician
- New Hyde Park, NY
- NPI 1790043479
-
dba Midwest Cardiovascular Specialists
- Cardiovascular Disease Physician
- Mishawaka, IN
- NPI 1194734483
-
- General Acute Care Hospital
- Manhasset, NY
- NPI 1366459570
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Glen Cove, NY
- NPI 1295743060
-
- General Acute Care Hospital
- New Hyde Park, NY
- NPI 1285641514
-
- General Acute Care Hospital
- Manhasset, NY
- NPI 1366459570
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1118275200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1343260800000",
"number": "1528062221",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "610 N MICHIGAN ST",
"address_2": "SUITE 400",
"city": "SOUTH BEND",
"state": "IN",
"postal_code": "466011077"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "610 N MICHIGAN ST",
"address_2": "SUITE 400",
"city": "SOUTH BEND",
"state": "IN",
"postal_code": "466011077",
"telephone_number": "574-647-8120",
"fax_number": "574-647-8111"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MITRA",
"first_name": "RAMAN",
"middle_name": "L.",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-06-09",
"last_updated": "2012-07-26",
"status": "A"
},
"taxonomies": [
{
"code": "207RC0001X",
"taxonomy_group": "",
"desc": "Internal Medicine, Clinical Cardiac Electrophysiology",
"state": "IN",
"license": "01045628A",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200102610",
"state": "IN"
}
],
"endpoints": [],
"other_names": []
}Other providers in South Bend, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.